rule of law: reexamining residency requirements for overseers

fivethirtyeight |  Pittsburgh’s police force is at loggerheads with the city it serves. Since 1902, the city has required police officers to live within the city limits, but an arbitration panel recently ruled in favor of allowing officers to live within 25 air miles of downtown. City officials want the requirement to remain in place, as do the people of Pittsburgh, who voted overwhelmingly in a referendum last year to keep it.

Residency requirements are hugely unpopular among police officers in Pittsburgh and in other cities with similar rules. Many cities and states have contested the constitutionality of these strictures on the grounds that they violate freedom of travel and the equal protection clause of the 14th Amendment. Even where they are in place, they are routinely flouted. Today, only 15 of America’s largest police departments have a strict residency requirement for police officers, and a majority of cops live outside the cities they serve.¹

Residency requirements for police officers have long been tied to better relations between cops and the communities they’re meant to protect. They continue to be seen by activists and politicians as a social good, part of the struggle to improve police force diversity. These concerns remain significant in Pittsburgh and in cities across the country, where demographic gaps plague police forces and are often linked to tensions with the public. The fatal shooting of an unarmed black teenager, Michael Brown, by a white officer in Ferguson, Missouri, in August threw into relief the lack of representation for minority groups on the police force there and in hundreds of other departments.

On that measure, Pittsburgh isn’t doing great: 25 percent of city residents are black, but only 12 percent of the police force is, according to a FiveThirtyEight analysis. The police force is 85 percent white, even though whites make up only 65 percent of the city’s population.

Pittsburgh is far from an outlier — a look at the demographic data of 75 cities and their police forces reveals it’s as average as it gets.² Although it’s impossible to establish causation between requiring cops to live in the city and the demographics of the police force in Pittsburgh or anywhere else, our analysis does show that departments with the rule tend to reflect their communities less than departments without it.

Residency requirements for city workers date to the turn of the 20th century, when aldermen would staff municipalities with a cadre of friends. Reformers in the 1920s argued that these requirements kept the best candidates from getting jobs and that they fostered a culture of corruption that pervaded cities and their governments. The laws were allowed to lapse until the 1970s, when the requirements had something of a renaissance. They were reintroduced and justified as a way of keeping tax revenue in a city and arresting the flight of the middle class to the suburbs. And according to Werner Z. Hirsch and Anthony M. Rufolo, two economists who wrote about residency requirements in 1983, the rules were also thought to increase a police officer’s “interest in the results of his work.” This interest was specified by Peter Eisinger, a professor at the University of Wisconsin, Madison, in a 1980 paper, in which he described the requirement as satisfying “the desire to create greater social symmetry between public servants and their clientele.”

perverse u.s. drug policies promote the justus growth industry

HuffPo |  To get your mind around just how dumb and perverse are our drug policies, you first have to absorb these astounding facts:

1. The U.S. has more deaths from drug overdoses than from car accidents.
2. Most are due to prescription narcotics, not street drugs.
3. Heroin deaths have also doubled in the past two years because patients first hooked on prescription narcotics often have to switch to cheaper street drugs.
4. States that have legalized medical marijuana have many fewer prescription narcotic overdoses than those that haven't.
5. Prescription narcotics are gateway drugs creating a new demographic of drug addiction -- older, whiter, suburban, and more female.
6. The Sackler family is famous and widely admired for its museum philanthropy; but is also infamous and deserves to be widely despised for its irresponsible drug pushing. Their drug company has been fined more than600 million for its criminal marketing of narcotics. Its pills cause more overdoses than any drug cartel.
7. Careless, sometimes criminal, MDs serve the same role for drug companies as corner pushers serve for drug cartels. Just one doctor in California was responsible for 400 emergency room visits.

We are fighting the wrong war on drugs.

The last 40 years prove conclusively that interdiction can't possibly win the war against the cartels. Illegal drugs are more available, stronger, and cheaper than ever. We have encouraged lawlessness and civil strife in every drug-producing nation. And we have cruelly and uselessly filled our prisons with people who might otherwise have had productive lives. The key to containing the cartels is to reduce demand for their products by legalization and by providing easy access to treatment and rehabilitation. The big losers if pot is legalized will be the drug cartels and the drug companies.

We couldn't possibly lose a battle to control Big Pharma -- if only our politicians and bureaucrats had the political will to engage in the fight.

charles ellison again: why the military and not medicine to ebola stricken africa?

theroot |  The Take turned to UCLA African American studies and Black Diaspora experts Dr. Peter James Hudson and Dr. Jemima Pierre to offer some expert insight into how effective that strategy is, whether it’s too militarized and if pharmaceuticals are calling the shots.  Hudson’s dissertation Dark Finance: An Unofficial History of Wall Street, American Empire and the Caribbean, 1889-1925 is under review and Pierre is author of The Predicament of Blackness: Postcolonial Ghana and the Politics of Race.

Jemima Pierre (@BLK_DIASPORAS): No matter the scale or severity of the outbreak, the Cuban response should be contrasted with that of the US and Europe. The Cubans have announced that they are sending an additional 300 doctors and nurses to Sierra Leone, Guinea, and Liberia to combat the spread of and to help those infected with Ebola. In total, the Cubans will have 461 healthcare professionals in West Africa combatting Ebola. This needs to be contrasted with, on one hand, the military response of the US government, and, on the other, the commercial response of American corporations like GlaxoSmithKline who are fast-tracking approval of what will become, undoubtedly, an extremely profitable vaccine.

Peter James Hudson (@darkfinance): For those who have been paying attention, the militarization of the Ebola response is not surprising. What’s not talked about much is the U.S. militarization of the African continent long before Ebola and the presumed threat of Boko Haram. The U.S. established AFRICOM (U.S.-Africa Command) under President George W. Bush back in 2008 for a number of reasons – not least of which to be prepared for the “threat” of China as it positions itself in the continuous scramble for African resources. But under Bush, few African countries wanted to host a U.S. military base, with the notable exception of Liberia’s president, Ellen Johnson Sirleaf. Under Obama, AFRICOM’s presence on the African continent expanded exponentially, and the U.S. has a military presence (often under the cover of “humanitarianism”) in just about every African country.

Pierre: We honestly think the Western response is racist and that the U.S. is acting in bad faith. The consistent privileging of white U.S. and European health care workers and missionaries needs to be seen as part of a broader context of racist practices around Africa in general, and the Ebola epidemic in particular. In the first case, one could accept the excuse that ZMapp is experimental and manufacturers didn’t want to give it to Africans for a number of historical and ethical reasons, including the long history of medical experimentation on people of color.  But, then, we find out that Dr. Sheikh Umar Khan, ­a highly skilled and respected Sierra Leonean medical practitioner [who succumbed to Ebola], ­was not even told about the experimental vaccine or given the chance to make a decision on taking it. It must also be noted that the one U.S. citizen that was said to have died of the disease was a black man, Patrick Sawyer, a Liberian-American who had been working as a consultant to the Liberian government. 

Hudson: Even if we put aside the discussion of a lack of “infrastructure to facilitate vaccination,” when it comes to dealing with Africa, ­ especially around epidemics, the optics look bad because the operations, quite simply, are racist. Given the history of U.S. racist representations of Africa, their cover was egregious. But then you see highly skilled African professionals ­like Dr. Khan and Dr. Olivet Buck ­ allowed to die, and white missionaries are saved.

Pierre: We find it dishonest when those in the west withholding vaccinations for Africans are claiming that they do not want to “experiment” on black African populations. There’s documented proof of experiments on African populations by western pharmaceutical companies. Africans are well aware of this history. And that history, along with the white west’s actions around Ebola, may also explain why many are questioning why this disease just suddenly emerged, and why there was already a secret vaccine in the works.

charles ellison putting in yoeman's work..., ebola-race-class

theroot | It’s a question that’s left people scratching their heads: How does a fully equipped hospital send an Ebola-infected man home—right after he arrived from West Africa and complained about being sick?

Some observers and public health experts are beginning to wonder if there’s an elephant in the room that no one wants to talk about: race and the politics of health insurance. Texas Health Presbyterian Hospital Dallas, the private medical campus where Thomas Eric Duncan is currently under care and isolation, still can’t explain exactly how medical staff let the 42-year-old Liberian national go home with useless antibiotics. Hospital officials have only said that Duncan’s travel history wasn’t “communicated,” and now mainstream media reports are stuck on everything from malfunctions in Presbyterian Hospital’s electronic record system to Duncan being dishonest about the level of his Ebola exposure when he left Liberia.

But few want to touch the pointy eggshells of race and class in the frantic discussion over Ebola as it enters the United States. Did Duncan get initially turned away because he is black and, possibly, uninsured?

Would it have been different if Duncan had been white and insured?

We may never know for sure, and it’s unclear if Duncan had insurance (it’s unlikely, considering that he’s a Liberian national on a U.S. visa).

What we do know is that Ebola response in the U.S. is under enormous scrutiny as experts wonder if an already challenged health system—currently undergoing an Affordable Care Act renovation—is really all that prepared for something that is scaring us like a Contagion script. And the specter of race is lurking not too far behind: When white American aid doctors in West Africa showed signs of the virus, they were rushed back to the U.S. ... stat. The same happened when a white freelance cameraman for NBC News in Liberia was immediately flagged for treatment.

But it’s been rough going for black Ebola sufferers—even when one manages to sneak into the U.S. and access one of the most advanced health care systems in the world.

Former District of Columbia Chief Medical Officer Dr. Ivan Walks, who led the response against Washington, D.C.’s first bioterrorism attack, believes it’s a question we need to start asking. “I was stunned,” Walks tells The Root. “You could put [Duncan’s] picture in the dictionary under what you look for when responding to Ebola. How do you miss that guy?”

That’s where factors such as Duncan’s race and level of insurance could have influenced the hospital’s first decision in either subtle or not-so-subtle ways. “There is a lot of research showing that different people get turned away in different places,” argues Walks. “So if they turned him away at first because he’s an African with no insurance, that would not be inconsistent with what we’ve seen over the years.”

Walks draws on lessons from a similar event in October 2001 when the D.C. area was struck by multiple anthrax attacks that hit postal facilities particularly hard. When two black Brentwood-facility postal workers—Thomas Morris Jr. and Joseph Curseen—dropped by Maryland hospitals complaining of anthrax-triggered symptoms, at the same time that news of the attack and Brentwood as a focus of investigation was plastered on every cable channel, they were sent home and died soon after.
I

hello, we're from the west and we're here to help you....,

natgeo |  The severity of this outbreak in West Africa reflects not only the transmissibility of the disease, but also the sad circumstances of poverty and the chronic lack of medical care, infrastructure, and supplies. That's really what this is telling us: that we need to try harder to imagine just what it's like to be poor in Africa. One of the consequences of being poor in Africa, especially in a country like Liberia or Sierra Leone, which have gone through a lot of political turmoil and have weak governance and a shortage of medical resources, is that the current outbreak could turn into an epidemic.

It's being spread because people are taking care of their loved ones at home. They're touching them, they're feeding them, they're washing them, they're cleaning up the vomit and the diarrhea that Ebola generates. That's a classic circumstance in which even health care workers are getting infected.

In addition, there are burial practices that involve washing the bodies and in some cases cleaning out the body cavities. In some cases, the funeral practices also involve a final touch or even a final kiss of the deceased person. And one of the things that's particularly nefarious about Ebola is that it continues to live in a dead person for some period of time after death. A person who's been dead for a day or two may still be seething with Ebola virus. So funeral practices can be a big factor in allowing it to be transmitted.

It's a combination of horrible circumstances. But the primary factor is poverty.

There's a cultural dimension to the way that disease is interpreted in Africa, isn't there? A kind of standoff between sorcery and science.

That's absolutely true. I know a little bit more about that element among the ethnic peoples of central Africa than West Africa. But in both regions there's a belief that these mysterious, invisible plagues are caused by sorcery and evil spirits—what we might call putting hexes on people.

There's a belief in some cultures that if a person experiences good fortune in financial terms and does not share the good fortune, when that person becomes ill with a mysterious fever and dies, people tend to say: "Aha! It was because he didn't share. It was the spirits who brought him down." There's also a belief in some cultures that if someone doesn't share, another person will direct these evil spirits to take that person down. There are a lot of different beliefs from culture to culture that involve the idea of sorcery. And that just adds to the confusion and the capacity for transmission.

When and where did Ebola first appear? (Belgian nuns with dirty needles in Yambuku!!!)

The first known outbreaks were in central Africa, in 1976: one in Zaire, the country that's now the Democratic Republic of the Congo, and one in Sudan. The Zaire outbreak is the more famous. It began in a place called Yambuku, a little mission town in north central Zaire. People were suddenly dying with these horrible symptoms, but nobody knew what it was. An international team led by Karl Johnson went in, and it was this team that first isolated and identified the virus. They named it after a nearby river, the Ebola River.

in 1976 I discovered Ebola - now I fear an unimaginable tragedy

guardian |  Yes, and our first thought was: "What the hell is that?" The virus that we had spent so much time searching for was very big, very long and worm-like. It had no similarities with yellow fever. Rather, it looked like the extremely dangerous Marburg virus which, like ebola, causes a haemorrhagic fever. In the 1960s the virus killed several laboratory workers in Marburg, Germany.

Were you afraid at that point?

I knew almost nothing about the Marburg virus at the time. When I tell my students about it today, they think I must come from the stone age. But I actually had to go the library and look it up in an atlas of virology. It was the American Centres for Disease Control which determined a short time later that it wasn't the Marburg virus, but a related, unknown virus. We had also learned in the meantime that hundreds of people had already succumbed to the virus in Yambuku and the area around it.

A few days later, you became one of the first scientists to fly to Zaire.

Yes. The nun who had died and her fellow sisters were all from Belgium. In Yambuku, which had been part of the Belgian Congo, they operated a small mission hospital. When the Belgian government decided to send someone, I volunteered immediately. I was 27 and felt a bit like my childhood hero, Tintin. And, I have to admit, I was intoxicated by the chance to track down something totally new.

In the end, you discovered that the Belgian nuns had unwittingly spread the virus. How did that happen?

In their hospital they regularly gave pregnant women vitamin injections using unsterilised needles. By doing so, they infected many young women in Yambuku with the virus. We told the nuns about the terrible mistake they had made, but looking back I would say that we were much too careful in our choice of words. Clinics that failed to observe this and other rules of hygiene functioned as catalysts in all additional Ebola outbreaks. They drastically sped up the spread of the virus or made the spread possible in the first place. Even in the current Ebola outbreak in west Africa, hospitals unfortunately played this ignominious role in the beginning.

After Yambuku, you spent the next 30 years of your professional life devoted to combating Aids. But now Ebola has caught up to you again. American scientists fear that hundreds of thousands of people could ultimately become infected. Was such an epidemic to be expected?

vice news: the fight against ebola

The current Ebola outbreak in West Africa began in Guinea in December 2013. From there, it quickly spread to Liberia and Sierra Leone. Cases also appeared in Senegal and Nigeria, and a separate outbreak appeared in the Democratic Republic of the Congo. Today, Liberia lies is at the center of the epidemic, with more than 3,000 cases of infection. About half of them have been fatal.

As President Barack Obama announced that he would be sending American military personnel to West Africa to help combat the epidemic, VICE News traveled to the Liberian capital of Monrovia to spend time with those on the front lines of the outbreak.

In Part 1, we meet confused and distressed people trying to receive treatment in the increasingly chaotic city, and speak to an ambulance driver doing his best to aid the sick.

Watch Part 2: 

marburg on the loose in uganda - still pretending this is murphy's law at work?

xinhua |  The deadly Marburg hemorrhagic fever has broken out in Uganda after samples taken to the Uganda Virus Institute tested positive, a top government official said Sunday.

Elioda Tumwesigye, minister of state for health told reporters that one person has so far died and 80 others are being monitored in central Uganda and the western district of Kasese.

"The Ministry of Health would like to inform the country of an outbreak Marburg which has so far killed one person. Another person who has developed signs is being monitored," he said.

He said the index case died on Sept. 28 after developing signs of Marburg which was later confirmed by laboratory tests. The minister said the deceased's brother has also developed signs and is currently under isolation.

He added that all the people that had contact with them are being monitored.

The Marburg virus was last reported in Uganda in 2012.

According to the World Health Organization, Marburg is a severe and highly fatal disease caused by a virus from the same family as the one that causes Ebola hemorrhagic fever.

According to the global health body, the illness caused by Marburg virus begins abruptly, with severe headache and malaise.

Case fatality rates have varied greatly, from 25 percent in the initial laboratory-associated outbreak in 1967, to more than 80 percent in the Democratic Republic of Congo from 1998-2000, to even higher in the outbreak that began in Angola in late 2004.

Currently some West African states are facing a related disease- - Ebola -- which has left more than 3,000 people dead. Endi

homeless dood infected in dallas riding in the infected ambulance after duncan...,

buzzfeed |  Authorities in Dallas have reportedly found Michael Lively, a homeless man they were looking for who may have come in contact with U.S. Ebola patient Thomas Eric Duncan. 

During a press conference on Sunday, Dallas County Judge Clay Lewis Jenkins did not identify the person, who he described as a “low-risk individual,” but a CBS reporter tweeted the man thought to be Lively. He reportedly rode in the same ambulance as Duncan. 

Judge Jenkins said that they were looking for the man as a precautionary measure, and asked him to come forward if he could hear him, stating that he had not committed any crimes.

“We are working to locate the individual and get him to a comfortable, compassionate place where we can monitor him and care for his every need for the full incubation period,” Jenkins said.

A few hours after officials first announced he was missing, Lively was located, according to Dallas city spokeswoman Sana Syed.

four thousand american troops in west africa are intended to prevent further outbreak in america...,

WaPo |  By early September, there was still no agreement among the major global health organizations and governments on how to respond to the epidemic. Unlike other disaster responses, such as the one after the earthquake in Haiti in 2010, no major U.N. operation was in place. And despite a 20-page "road map" that the WHO had introduced, it was unclear how anyone would put it into effect.

"Six months into the worst Ebola epidemic in history, the world is losing the battle to contain it," Liu, of Doctors Without Borders, told the United Nations on Sept. 2. For the first time, she implored countries to deploy their military assets - something her organization had previously opposed for health emergencies.

World Bank President Jim Yong Kim was beyond frustrated. Kim, a doctor and an expert on infectious diseases, called an emergency meeting for Sept. 3 that would include major decision-makers from the government and the private sector.

About 50 people crowded into the 12th-floor conference room at the World Bank's Washington headquarters. Gayle Smith from Obama's National Security Council was on the telephone. A senior WHO official participated by video link. The session lasted two hours.

Frieden showed up and had a dire warning: The response was like "using a pea shooter against a raging elephant."

Kim warned, "The future of the continent is on the line."

By the first week of September, senior officials across the U.S. government had come to a grim realization: The civilian response was never going to happen fast enough to catch up with the epidemic. The CDC had managed to put more than 100 staff members on the ground and the U.S. disaster relief team had dispatched 30 more, but they and other aid workers were facing too big of a challenge. Only the U.S. military had the capacity to move with enough speed and scale.

The White House was talking to the Pentagon about deploying a field hospital to treat any health-care workers who might get sick, an effort to reassure potential volunteers. U.S. military planners in West Africa were telling Washington that 500 treatment beds were needed for sick patients. A host of agencies across the government had to work out complicated logistics.

On Sept. 7, Obama said on NBC's "Meet the Press" that he intended to use the U.S. military to provide equipment, logistical support and other aid to West Africa.

But the region now had thousands of confirmed Ebola cases, and there was nowhere to treat the sick and the dying. On Sept. 9, Sirleaf sent Obama an urgent plea:

"I am being honest with you when I say that at this rate, we will never break the transmission chain and the virus will overwhelm us," she wrote.

The next day, high-level administration officials met at the White House to discuss military options. "People were asked to do more homework on the how," and then report back two days later, on Sept. 12, a senior official said.

hajj will not be an ebola propagation vector...,

pbs  |  With the arrival of approximately two million people from around the world in Saudi Arabia for the annual hajj pilgrimage, there are a group of pilgrims who were not welcomed.

The Saudi government has banned the entry of travelers from three countries currently dealing with the Ebola epidemic: Liberia, Guinea and Sierra Leone. The decision to reject visa requests from these countries has affected 7,400 people, according to the Associated Press.

Hospitals in Saudi Arabia are also preparing in the event of an outbreak by setting up isolation and surgery units as well as dispatching medical staff to airports.

Despite banning pilgrim seekers from West Africa, Saudi officials are granting visas to pilgrims travelling from Nigeria. Saudi Arabia’s King Abdulaziz International Airport has provided them with two exclusive lounges as a precaution.

“So far 118,000 pilgrims have arrived by air from Nigeria. There was not a single suspected case of the deadly virus among anyone of them,” said Abdul Ghani Al-Malki, supervisor of hajj affairs at the airport.

israel needed no ebola to make its position crystal clear...,

JTA |  The Israeli government reportedly denied a U.S. request to assist in medical relief in Ebola-stricken West African countries, but an Israeli NGO is already on the ground in Sierre Leone.

Defense Minister Moshe Yaalon rejected the request, which first came to the Israeli Foreign Ministry from Samantha Power, the U.S. envoy to the United Nations, Ynet reported Wednesday. In the request, Power cited Israel’s past successes in providing medical relief in disaster-stricken areas.

The Foreign Ministry favored the request, Ynet said, but sought the approval of the Defense Ministry. Yaalon denied it, citing the risk of infection to Israeli medical teams and the army troops needed to secure them in West Africa. Israel’s assistance was sought in Liberia and Sierra Leone.

Meanwhile, the Israeli non-governmental organization IsraAid, which receives support from U.S. Jews, met this week with the first lady of Sierra Leone and is in discussions with local authorities about how to provide psychological and social counseling and increase local health awareness. IsraAid founder Shachar Zahavi told JTA that his organization is also in the process of recruiting medical personnel to join those treating the affected area in Liberia and Sierra Leone.

In the coming months IsraAid plans to send over 30 experts in post-traumatic stress  disorder prevention and stress management to West Africa to conduct intensive training for local social workers and health workers.

The idea, according to IsraAid is “to provide them with practical tools in stress management and trauma prevention techniques. The program will be based on IsraAid’s world-renowned holistic approach developed and implemented after disasters in Haiti, Japan, South Sudan, Jordan and other countries around the world.”

even the hittites used "cursed rams" against their enemies...,

ibtimes |  If latest reports are to be believed, the Islamic State militants might be conspiring to deliberately infect jihadists with the deadly Ebola virus and send them to America in order to spread the disease in the US – an event that could see America being attacked in a new pseudo-war.

The Israeli News Agency, a site which claims to be Israel's first online news organisation has confirmed the authenticity of the report saying it "clears all news items relating to Israeli security with the Israel government press office."

The agency said, citing "Israeli security sources", that dozens of ISIS fighters in Syria have fallen ill and had symptoms of Ebola. This news quickly ignited a new conspiracy theory claiming that ISIS is planning to send Ebola-infected militants into the US to spread the disease.

"While Western nations fighting the Islamic State might consider this reported Ebola outbreak among radical jihadists to be welcome news, there is a very big, very dangerous downside to Islamic terrorists being carriers of the virus," Norvell Rose, the winner of numerous journalism honours, writes for WesternJournalism.com.

The article also cites the Israeli News Agency (INA) for inference into why the news could prove dangerous for the Americans. The INA in its report quoted a source it identified only as "AVi", who is "a global anti-terrorism consultant" as saying: "We know that ISIS has training camps in Africa and it is highly possible that this is where contact with the virus was made.

"This would add new meaning to the US stating that no boots would be on the ground as both missiles and Ebola penetrates one of the worst evils that the world has ever known."

The theory was further bolstered by reports of a direct threat from the ISIS militants who said they would spread the Ebola virus to the United States and its allies if they continue to wage war on the organisation inside Syria and Iraq as reported by Shoebat.com, a website created by Walid Shoebat who was a radicalised Muslim until 1994 when he converted to Christianity.

Shoebat quoted a statement from ISIS published in another website called Vetogate.com. The statement reportedly said: "Followers and soldiers of the Islamic State are mostly suicide bombers and all of them are ready not only to carry Ebola, but to drink Ebola if they were asked to carry and spread it in the United States. This is not difficult but we need a decision from the leaders jihadist (sic)."

The statement further said: "The process of spreading disease is not difficult. It can easily be transported in a bottle in your bag from Africa to America. The contents of the bottle can then be released in an air-conditioning duct or put it in the public drinking water."

throwing emr and nurse under the bus to conceal the fact that physician was following profit maximization sop...,

businessweek |  The Dallas hospital treating the first Ebola case diagnosed in the U.S. sent the patient, Thomas Duncan, home the first time he showed up because the doctors who saw him never learned that he’d just come from West Africa. The hospital has blamed a flaw in its electronic health records for keeping information collected by a nurse, including Duncan’s travel history, from being presented to the treating physician, who mistook Duncan’s symptoms for a low-level infection, on Sept. 25.

The apparent mistake meant Duncan was not admitted and isolated until Sept. 28. That increased the risk of infection for those he came in contact with while he was sick, including his family, who are now quarantined in their Dallas apartment. It also widened the circle of contacts that public health officials must trace and monitor for symptoms. 

America’s risk of an Ebola epidemic remains vanishingly small. The country has the public health resources and hospital capacity to stop the spread of the infection, which is only transmitted through direct contact with bodily fluids after a patient exhibits symptoms. The misstep at Texas Health Presbyterian Hospital Dallas, though, indicates something patients should be spooked about: the very real chance that errors, oversights, or deviations from established procedures could kill them.

covering up for the a-hole md who didn't check the nurse's notes and put presbyterian's bottom line over patient-zero's well-being...,

newsmax |  Dallas doctors apparently never saw a nurse's note that an emergency room patient with fever and pains had recently been in Africa, and he was released into the community while infected with deadly Ebola.

It remains unclear why, despite the hospital's attempt at an explanation Friday. Early in the day, Texas Health Presbyterian Hospital said in a statement that a nurse's notes on the infected patient, Thomas Eric Duncan, were contained in records that a physician wouldn't see. Friday night, a spokesman for the institution said that wasn't so.

"We would like to clarify a point made in the statement released earlier," Wendell Watson, a spokesman for the hospital, wrote in an e-mail. "As a standard part of the nursing process, the patient's travel history was documented and available to the full care team in the electronic health record (EHR), including within the physician's workflow."

There "was no flaw in the EHR in the way the physician and nursing portions interacted related to this event," Watson said.

The changing message came after the hospital faced criticism from other medical professionals about the actions taken prior to the patient's release. Ashish Jha, a health policy professor at Harvard University's School of Public Health in Boston, said no matter what, the doctor responsible should have double-checked the man's travel history before he was sent back out into the community.

‘Logic Flaws' 

"There are so many flaws in the logic of ‘The EMR system made us to do it,'" Jha said in a telephone interview Friday, referring to the hospital's initial statement. "When a patient walks in the ER with a fever, the standard question is ‘Have you traveled?' I don't understand why that question wasn't asked by the physician."

Two days after being released, Duncan returned in an ambulance to the Dallas hospital, was placed in isolation and subsequently confirmed as having the deadly disease.

Wendell Watson, a spokesman for the hospital, said earlier Friday that the hospital had wrongly designed its digital record system so not all of a nurse's notes are visible to doctors. Its not clear from the clarification sent to media just before midnight what actually happened.

utah, honolulu, and toronto all clear, chocalate city gets a live one though...,

WaPo |  But before an Ebola case was confirmed in Dallas this week, there had not been a single Ebola diagnosis in the United States.

Potential Ebola patients who were evaluated in New York, California, New Mexico and Miami all tested negative for the virus.

People with Ebola are not contagious until they begin showing symptoms, which include a fever of greater than 101.5 degrees Fahrenheit, severe headache and vomiting. And you can only get Ebola through contact with a contagious person's bodily fluids.

Several Ebola patients have been transported from West Africa to the United States, including three Americans who were in Liberia — doctors Richard Sacra and Kent Brantly and missionary worker Nancy Writebol — who have already been discharged after they were successfully treated here. A Liberian American, Patrick Sawyer, fell ill after traveling to Nigeria and died of the disease.

The NIH in Bethesda recently admitted an American patient who had been exposed to Ebola.

On Thursday night, NBC News announced that a freelance cameraman working for the network in Liberia has tested positive for Ebola and will return to the United States for treatment.

In Maryland, all health providers and labs are required to report suspected Ebola cases to the state Department of Health and Mental Hygiene immediately, said spokesman Christopher Garrett. The state agency works with local health departments to ensure that proper procedures, including isolation, are followed; information has been distributed to hospitals, nursing homes, labs and other providers.

where uncle pookie an'em go after aerosolizing that vomit and tracking their shoes through the runoff?

nurses not having it...,

nationalgeographic |  In a poll of 400 National Nurses United members released Wednesday, 60 percent said their hospital is not prepared for the Ebola virus, and more than 80 percent said their hospital had not educated them about Ebola or communicated any policy regarding potential patients infected with the virus.

Nearly one-third of the nurses said their hospitals lacked sufficient supplies of face shields and fluid-resistant gowns needed to protect them against the virus.

The union, which staged a "die-in" Monday on the Las Vegas strip to call attention to their Ebola concerns, blamed a lack of information and proper systems—rather than human error—for the decision last week to let Duncan leave the hospital when he first turned up complaining of fever and abdominal pain and mentioned his recent trip to Liberia. He was sent home but was readmitted on Sunday, much sicker.

It's not clear why the information about his recent travels did not raise a red flag in the emergency department, and why he was not suspected of having Ebola.

In a prepared statement in response to questions about the nurses' concerns, the American Hospital Association released a statement from Ken Anderson, the chief operating officer for the organization's Health Research and Educational Trust.

"We strongly recommend that hospitals follow CDC guidance in identifying potential Ebola patients," the statement said. "While in the Dallas case the hospital has acknowledged that it had a regrettable lapse in communication, the AHA is redoubling our efforts to make sure hospitals are aware of the latest CDC guidance, including checklists and screening criteria."

Frieden described the missed opportunity to catch Duncan's disease earlier as a "teachable moment," and said the CDC is redoubling its efforts to provide clear and useful information to hospitals about the Ebola risk.

"Essentially, any hospital in the country can safely take care of a patient with Ebola," he said, by providing a private room and bathroom, and by "rigorous, meticulous training" of staff. But Frieden acknowledged that the CDC is still working through the challenge of how to safely dispose of medical waste from Ebola patients.

the most dangerous path of transmission is health officials lying in an attempt to prevent panic

americanthinker |   The public has been misinformed regarding human-to-human transmission of Ebola. Assurances that Ebola can be transmitted only through direct contact with bodily fluids need to be seriously scrutinized in the wake of the West Africa outbreak.

The Canadian Health Department states that airborne transmission of Ebola is strongly suspected and the CDC admits that Ebola can be transmitted in situations where there is no physical contact between people, i.e.: via direct airborne inhalation into the lungs or into the eyes, or via contact with airborne fomites which adhere to nearby surfaces. That helps explain why 81 doctors, nurses and other healthcare workers have died in West Africa to date. These courageous healthcare providers use careful CDC-level barrier precautions such as gowns, gloves, and head cover, but it appears they have inadequate respiratory and eye protection. Dr. Michael V. Callahan, an infectious disease specialist at Massachusetts General Hospital who has worked in Africa during Ebola outbreaks said that minimum CDC level precautions

“led to the infection of my nurses and physician co-workers who came in contact with body fluids.”

Currently the CDC advises healthcare workers to use goggles and simple face masks for respiratory and eye protection, and a fitted N-95 mask during aerosol-generating medical procedures. Since so many doctors and nurses are dying in West Africa, it is clear that this level of protection is inadequate. Full face respirators with P-100 (HEPA) replacement filters would provide greater airway and eye protection, and I believe this would save the lives of many doctors, nurses, and others who come into close contact with, or in proximity to, Ebola victims.

The United States Army Medical Research Institute of Infectious Diseases conducted a monkey to monkey Ebola study in December 1995, published in The Lancet, Vol. 346. (Here is a link to the abstract, but the entire article must be purchased.) Several Rhesus monkeys were infected with Zaire Ebola by intramuscular injection while three control Rhesus monkeys were kept in cages separated 10 feet from the infected monkeys. All of the injected monkeys died of Ebola by day 13 and 2 out of 3 control monkeys died of Ebola by 8 days after that. The authors of this study concluded that:

"The exact mode of transmission to the control monkeys cannot be absolutely determined, although the pattern of pulmonary antigen staining in one of the control monkeys was virtually identical to that reported in experimental Ebola virus aerosol infection in rhesus monkeys, suggesting airborne transmission of the disease via infectious droplets... Fomite or contact droplet transmission of the virus between cages was considered unlikely. Standard procedures in our BL4 containment laboratories have always been successful in the prevention of transmission of Ebola or Marburg virus to uninflected animals. Thus, pulmonary, nasopharyngeal, oral, or conjunctival exposure to airborne droplets of the virus had to be considered as the most likely mode of infection... Our present findings emphasize the advisability of at-risk personnel employing precautions to safeguard against ocular, oral, and nasopharyngeal exposure to the virus."

Another NHP to NHP (monkey-to-monkey) study was published in July of this year. Rhesus monkeys were infected with Ebola via intramuscular injection and they were terminated on day 6 after becoming unresponsive, but without developing vomiting, diarrhea, or apparent respiratory illness. Ebola virus was detected in their blood, and genetic fragments of Ebola were found in their nose, mouth, and rectum, but no intact infectious Ebola virus was found. 

Control Cynomolgus monkeys were caged 1 foot away from the infected Rhesus monkeys but did not become infected with Ebola. This experiment is not a helpful comparison in human to human Ebola infections which are characterized by GI (vomiting & diarrhea) and respiratory (cough and expectoration of sputum) shedding of the intact infectious virus. The monkeys in this year’s study simply died too fast, not allowing time for them to shed infectious Ebola particles. It goes without saying that monkeys which do not shed infectious Ebola particles cannot transmit Ebola to other monkeys. Had this year’s rhesus monkeys been infected by the nasal route, as was the case in a pig-to-monkey experiment in 2012, or if they had lived up to 13 days as in the 1995 study, allowing time for intact infectious Ebola virus to appear, and thus more closely matching human Ebola disease, then we may well have seen monkey-to-monkey airborne transmission of Ebola. The authors of this study concluded that:

“NHPs [non-human primates such as monkeys] are known to be susceptible to lethal EBOV infection through the respiratory tract [just like humans] putting the onus of the transmission on the ability of the source to shed infectious particles.”

We know that airborne transmission of Ebola occurs from pigs to monkeys in experimental settings. We also know that healthcare workers like Dr. Kent Brantly are contracting Ebola in West Africa despite CDC-level barrier protection measures against physical contact with the bodies and body fluids of Ebola victims, so it only makes sense to conclude that some -- possibly many -- of these doctors, nurses, and ancillary healthcare workers are being infected via airborne transmission. It makes perfect sense that sick humans, as they vomit, have diarrhea, cough, and expectorate sputum, and as medical procedures are performed on them, have the ability to shed infectious Ebola particles into the air at a similar or higher level compared to Sus scrofa (wild boar) in the pig-to-monkey study.

clear thinking on what makes an airborne and highly contagious disease a weapon - no fancy gimmicks required!

shtfplan |  The Centers for Disease Control and medical experts around the country say they have procedures in place to deal with Ebola and pandemics.

But according to one paramedic in Dallas, neither he or anyone else was told that the ambulance they were driving was the same one used to transport Ebola patient Thomas Duncan to the hospital.

A Dallas paramedic claimed he drove the ambulance that the US Ebola patient was transported in and that he was not contacted by anyone about the potential exposure. He claims he drove the ambulance sometime after the patient was transported. The Dallas Fire Department left the ambulance that transported Ebola patient Thomas Duncan to the hospital in service for at least 48 hours before putting it in quarantine on Wednesday. 
Breitbart

It is not known how many paramedics drove the ambulance during the 48 hour period or how many patients were transported.

The incident is the latest in a string of procedural breakdowns that included initially sending Duncan home from the hospital with antibiotics and failing to properly decontaminate the apartment in which he stayed during the onset of symptoms.

Officials continue to insist that America’s medical infrastructure is prepared to handle Ebola.

In about 21 days we’ll know if they are right.

People are already starting to panic. What happens in three weeks if this starts showing up in schoolchildren or other metro areas?  Fist tap Big Don.